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, t <br /> Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of g <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,cos. Adm. Code <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size.Plan must County Bur n e- <br /> indude,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. 03d - S 3 dl BOO <br /> Please print all information. Reviewed by Date n <br /> Pe'sonal informfion you Provide may be used for secondary Purposes(Privacy Law,s.15.04(1)(m)). 2/ U'( <br /> Property Owner Property Location <br /> D e n vl, OV e(2 U GovL Lot /V E 1/4 Ill kA14 SOL 3 T y l N R I b E(or)( <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> City State Zip Code Phone Number ❑city []Village ®Town Nearest Road <br /> S,tneestane /n p! I s-SO71 1 (3),0) �4d•' 3/6 S` 5klur W I Se-ven+h IOL- <br /> [Z New Construction Use:❑ Residential/Number of bedrooms Code derived design flow rate 79 GPD <br /> ❑Replacement ® Public or commercial-Describe: __ O FF 'e-,-- 6"i 1 4r - <br /> Parent material i a t Ori F?- Flood Plain elevation if applicable A111V ft. <br /> General comments Sys, I e✓ '� y to 95.Df/ <br /> and recommendations: <br /> a Boring# ❑ Boring <br /> [@ pit Ground surface elev. 9r5'4 ft. Depth to limiting factor 7 70( in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'EfW <br /> 0- 6 7•S-51R 3�;, — ✓ o z le— cS <br /> a�+ G�3,1 7.s V4 y/y /s /nlsbk ,,, s 3sn 7 /• .l <br /> 3 3.t -SI s YR "/6 - S O S6- ,h 1 C S ,t fvt .7 <br /> y S7--7.. 7.s fR r1y - s osG- H, 1 G s .7 1• d <br /> Boring# ❑ Boring <br /> © Pit Ground surface elev. 96.0 ft. Depth to limiting factor 7 -7(0 in. <br /> Soil ticetion Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 <br /> b-34 7.s-9Q `/'I — if /m1f6k m/ CrS 3rr, • 7 Aa( <br /> 3 <br /> 31t. 3-0 -5-y-/{ y/6 S 0S6 viif GS 1. rri .7 <br /> so. 76 7• s/y _ s os6 ,,I., I 65 - 17 /.d <br /> Effluent#1 =BOD >30:5 220 mg/L and TSS>30<150 mg/L `Effluent#2=BOD <30 mg/L and TSS<30 mg/L <br /> CST Name(Please Print) Signature //11 QQ CST Number <br /> (Jf+MB-s Uf1N/C-15 SC/dloce/2 �73/l,4&- <br /> Address VDate Evaluation Conducted Telephone Number <br /> a 7760 /1w 3S" websl<-er wi :%y9093 3-dq -04 7/S- SGIo- 769'61'- <br />